The coronavirus disease 2019 (COVID-19) pandemic is associated with various painful symptoms and could potentially lead to a significant increase in patients experiencing chronic pain. While churches had to close their doors during the pandemic, emerging scientific data suggest that, when our spiritual needs are not met, our well-being can be in jeopardy, and it could also increase the experience of physical pain. The aim of this article is, therefore, to explore the role that spirituality and religion (...) could play in addressing physical pain. An interdisciplinary approach is used with the goal of integrating different insights so as to construct a more comprehensive understanding of the problem. Literature in the disciplines of humanities, health sciences, as well as social sciences is explored to identify the concepts of physical, social and spiritual pain and to explore the link between the different dimensions of pain. It became clear that physical, social, and spiritual pain can influence one another, and addressing one kind of pain can also improve pain in another dimension. Several spiritual and religious interventions were found in the literature and confirmed to be valuable in helping patients cope with physical pain, such as accepting and giving meaning to pain, prayer, meditation, scripture, music, support from the religious community and helping others.Contribution: This article highlights the importance of an interdisciplinary approach that incorporates religion and/or spirituality to address physical pain during and after the COVID-19 pandemic. (shrink)

In the next few years, biotechnology will continue to develop a wide variety of functional foods, foods whose benefits go well beyond basic nutrition. Minors are a major potential market for bioengineered foods that are promoted not as sustaining health but rather as supporting desired lifestyles through the enhancement of physical, athletic, intellectual, or social performance. The experience of other industries suggests that such biomarketing is likely to create a variety of highly public ethical controversies. After a discussion of (...) some of these potential issues, suggestions on how companies and industries can work with marketing ethicists and child advocates to limitnegative impacts on children and youth are presented. That discussion includes a preliminarily analysis of some of the considerations that should be involved in the initial development of a model of biomarketing ethics and in the use of that model to prevent ethical abuses. (shrink)

Two of Sophocles' surviving tragedies contain scenes that portray the main character in excruciating pain for a sustained period of time: Philoctetes and Trachiniae. This article discusses three important stages in the reception history of these pain scenes: (1) Hercules Oetaeus, attributed to Seneca, (2) Gotthold Ephraim Lessing's Laocoon treatise, and (3) recent European adaptations. In each case, it analyzes how the later playwrights, directors, and theorists responded to certain complexities inherent in Sophocles' representation of pain. The (...) conclusion considers this reception history overall. (shrink)

Context and AimsAlthough some exercise-based interventions have been associated with lower levels of pain and performance-related musculoskeletal disorders among musicians, the evidence is still mixed. Furthermore, little is known about musicians’ general engagement in physical activity, their knowledge of PA guidelines, or the relevant training they receive on pain prevention and the sources of such training. Similarly, little is known about the relationship between PA and PRMDs and other risk factors for PRMDs.MethodsFollowing a cross-sectional correlational study design, (...) both standardized andad hocmeasurements were used to investigate self-reported PA [International Physical Activity Questionnaire – Short Form ], knowledge of PA guidelines, and barriers to engaging in PA [Centers for Disease Control ; Determinants of Physical Activity Questionnaire ]; sedentary behavior [Sedentary Behavior Questionnaire ]; pain [36-Item Short Form Survey Instrument ] and PRMDs ; reported physical exertion ; anxiety [Hospital Anxiety and Depression Scale ]; practice behaviors ; and relevant training among conservatoire students in the United Kingdom. The entire set of questionnaires was administered both online and via hard copies between June 2017 and April 2018.ResultsDemographic information was obtained from 111 respondents, mostly undergraduate students from seven conservatoires. They reported high levels of engagement in PA, despite poor knowledge of PA guidelines. Teachers were the most frequently mentioned source of pain prevention information, and 62% agreed that they had received advice on why they should engage in cardio PA. Sedentary behavior was comparable to normative data. Levels of bodily pain and PRMDs were low, but 43% showed “abnormal” clinical anxiety and found playing their instruments “somewhat hard” on average. Bodily pain interfering with practice and performance was positively correlated with frequency and severity of PRMDs, anxiety, and RPE. Frequency and severity of PRMDs were also associated with sedentary behavior at the weekend. Anxiety was associated with RPE. No association was found between PA and PRMDs.ConclusionThe relationship between PA and PRMDs and pain remains unclear and needs further investigation. While health education needs to be improved, other pathways may need to be taken. Given the high levels of anxiety, the ideology of Western classical music itself may need to be challenged. (shrink)

Using conversation analysis and a collection of naturally occurring US primary care consultations, this article explores the search for pain during primary care physical exams. Inhabiting this activity is a ‘collision’ of expertise between physicians’ clinical knowledge about bodies and patients’ knowledge about their bodies. I show how patients responding to questions like does that hurt? tacitly guide physicians to their pain using pain displays, glottal cutoffs and response delays to observably react to the physician’s touch, (...) delineating painful from non- or less-painful areas. Physicians respond to these practices by altering the trajectory of their touch in coordination with the patient’s embodied behavior. In this local context, physicians’ touch not only constrains patients to affirm pain in a particular location, but it is also a unique affordance for patients to guide physicians while nonetheless preserving the physician’s authority over where to test for pain, thereby maintaining the physical examination activity framework. (shrink)

As the expansion of the Internet and the digital formatting of all kinds of creative works move us further into the information age, intellectual property issues have become paramount. Computer programs costing thousands of research dollars are now copied in an instant. People who would recoil at the thought of stealing cars, computers, or VCRs regularly steal software or copy their favorite music from a friend's CD. Since the Web has no national boundaries, these issues are international concerns. The contributors-philosophers, (...) legal theorists, and business scholars, among others-address questions such as: Can abstract ideas be owned? How does the violation of intellectual property rights compare to the violation of physical property rights? Can computer software and other digital information be protected? And how should legal systems accommodate the ownership of intellectual property in an information age? Intellectual Property is a lively examination of these and other issues, and an invaluable resource for librarians, lawyers, businesspeople, and scholars. (shrink)

Physical pain has no voice, but when it at last finds a voice, it begins to tell a story, and the story that it tells is about the inseparability of these three subjects, their embeddedness in one another. (Scarry, BP, 3).

Part philosophical meditation, part cultural critique, The Body in Pain is a profoundly original study that has already stirred excitement in a wide range of intellectual circles. The book is an analysis of physical suffering and its relation to the numerous vocabularies and cultural forces--literary, political, philosophical, medical, religious--that confront it.Elaine Scarry bases her study on a wide range of sources: literature and art, medical case histories, documents on torture compiled by Amnesty International, legal transcripts of personal injury (...) trials, and military and strategic writings by such figures as Clausewitz, Churchill, Liddell Hart, and Kissinger, She weaves these into her discussion with an eloquence, humanity, and insight that recall the writings of Hannah Arendt and Jean-Paul Sartre.Scarry begins with the fact of pain's inexpressibility. Not only is physical pain enormously difficult to describe in words--confronted with it, Virginia Woolf once noted, "language runs dry"--it also actively destroys language, reducing sufferers in the most extreme instances to an inarticulate state of cries and moans. Scarry analyzes the political ramifications of deliberately inflicted pain, specifically in the cases of torture and warfare, and shows how to be fictive. From these actions of "unmaking" Scarry turns finally to the actions of "making"--the examples of artistic and cultural creation that work against pain and the debased uses that are made of it. Challenging and inventive, The Body in Pain is landmark work that promises to spark widespread debate. (shrink)

In Why pains are not mental objects Guy Douglasrightly argues that pains are modes rather than objects ofperceptions or sensations. In this paper I try to go a stepfurther and argue that there are circumstances when pains canbecome objects even while they remain modes of experience.By analysing cases of extreme pain as presented by Scarry,Sartre, Wiesel, Grahek and Wall, I attempt to show thatintense physical pain may evolve into a force that, likeimagination, can make our most intense (...) state of experiencebecome a mental object. I shall finally argue that, thoughextreme pains cannot serve as paradigm cases, they do showthe general importance of taking pain states to be objects. (shrink)

Chronic pain affects a large part of the population causing functional disability, being often associated with coexisting psychological disorders, such as depression and anxiety, besides cognitive deficits, and sleep disturbance. The world elderly population has been growing over the last decades and the negative consequences of chronic pain for these individuals represent a current clinical challenge. The main painful complaints in the elderly are related to neurodegenerative and musculoskeletal conditions, peripheral vascular diseases, arthritis, and osteoarthritis, contributing toward poorly (...) life quality, social isolation, impaired physical activity, and dependence to carry out daily activities. Organ dysfunction and other existing diseases can significantly affect the perception and responses to chronic pain in this group. It has been proposed that elderly people have an altered pain experience, with changes in pain processing mechanisms, which might be associated with the degeneration of circuits that modulate the descending inhibitory pathways of pain. Aging has also been linked to an increase in the pain threshold, a decline of painful sensations, and a decrease in pain tolerance. Still, elderly patients with chronic pain show an increased risk for dementia and cognitive impairment. The present review article is aimed to provide the state-of-art of pre-clinical and clinical research about chronic pain in elderly, emphasizing the altered mechanisms, comorbidities, challenges, and potential therapeutic alternatives. (shrink)

: Psychogenic pain is considered to be pain that has a psychological origin. In this paper, I provide a brief history of the ways in which such pain has been interpreted and classified, highlighting the problem that psychogenic pain is typically defined by excluding organic evidence that could account for the sufferer’s experience. This has led to ambiguous disease classifications, which challenges the authenticity of the patient’s suffering. Today psychogenic pain is no longer considered a (...) valid diagnosis, because it is deemed to stigmatize the patient by implying that their pain is imaginary. But such stigmatization continues in the modern approach to chronic pain. Addressing this issue requires us to understand the relationship between “emotional” and “physical” pain and acknowledge the reality of all suffering. Radden tackles these issues by showing that even though pain and suffering can be accompanied by mistaken beliefs, such experiences cannot be delusional. Keywords: Psychogenic Pain; Imaginary Pain; Chronic Pain; IASP; DSM Dolore psicogeno e dolore immaginario Riassunto: Con dolore psicogeno si intende un dolore di origine psicologica. In questo lavoro presento una breve storia delle interpretazioni e classificazioni di questa forma di sofferenza, evidenziando che queste si sono fondate perlopiù sull’esclusione di evidenze organiche a giustificazione dell’esperienza del sofferente. Ciò ha portato ad ambigue classificazioni di malattia che mettono in discussione l’autenticità della sofferenza del paziente. Oggi, quella di dolore psicogeno non è più considerata una diagnosi valida perché ritenuta stigmatizzante, implicando che il dolore del paziente sia immaginario. Ciononostante, la stigmatizzazione persiste nell’approccio odierno al dolore cronico. Affrontare questo problema comporta la comprensione della relazione tra dolore “emozionale” e dolore “fisico” ed il riconoscimento della realtà di tutte le forme di sofferenza. Nel suo lavoro, Radden esamina queste tematiche mostrando che, sebbene esperienze di dolore e sofferenza possano essere accompagnate da credenze errate, le esperienze stesse non possono essere illusorie. Parole chiave: Dolore psicogeno; dolore immaginario; dolore cronico; IASP; DSM. (shrink)

What does feeling a sharp pain in one's hand have in common with seeing a red apple on the table? Some say not much, apart from the fact that they are both conscious experiences. To see an object is to perceive an extramental reality -- in this case, a red apple. To feel a pain, by contrast, is to undergo a conscious experience that doesn't necessarily relate the subject to an objective reality. Perceptualists, however, dispute this. They say (...) that both experiences are forms of perception of an objective reality. Feeling a pain in one's hand, according to this view, is perceiving an objective condition of one's hand. Who is closer to truth? Because of such metaphysical issues, the subjectivity of pains combined with their clinical urgency raises methodological problems for pain scientists. How can a subjective phenomenon be studied objectively? What is the role of the first-person method in science? Some suggest that the subjectivity of pains is due to their metaphysical irreducibility to purely physical processes in the nervous system. Can this be true? The study of pain and its puzzles offers opportunities for understanding such larger issues as the place of consciousness in the natural order and the methodology of psychological research. In this book, leading philosophers and scientists offer a wide range of views on how to conceptualize and study pain. The essays include discussions of perceptual and representationalist accounts of pain; the affective-motivational dimension of pain; whether animals feel pain, and how this question can be investigated; how social pain relates to physical pain; whether first-person methods of gathering data can be integrated with standard third-person methods; and other methodological and theoretical issues in the science and philosophy of pain. (shrink)

Pain is the most prominent member of a class of sensations known as bodily sensations, which includes itches, tickles, tingles, orgasms, and so on. Bodily sensations are typically attributed to bodily locations and appear to have features such as volume, intensity, duration, and so on, that are ordinarily attributed to physical objects or quantities. Yet these sensations are often thought to be logically private, subjective, self-intimating, and the source of incorrigible knowledge for those who have them. Hence there (...) appear to be reasons both for thinking that pains (along with other similar bodily sensations) are physical objects or conditions that we perceive in body parts, and for thinking that they are not. This apparent paradox is one of the main reasons why philosophers are especially interested in pain. One increasingly popular but still controversial way to deal with this apparent paradox is to defend a perceptual or representational view of pain, according to which feeling pain is in principle no different from undergoing other standard perceptual processes like seeing, hearing, touching, etc. But there are many who think that pains are not amenable to such a treatment. Although it was the treatment of pain as a sensory-discriminative experience that had dominated the philosophical discussions throughout most of the twentieth century, attention to pains’ affective-motivational dimension has gained prominence in recent years. (shrink)

Receiving a diagnosis of cancer can be devastating. Cancer continues to be one of the most feared diagnoses, and experiencing pain is a major fear for people diagnosed with cancer. Cancer pain is complex in aetiology and can be acute or chronic and can be caused by various compression, ischaemic, neuropathic or inflammatory processes. Many people with cancer will experience excruciating pain, which is often underreported and undertreated. The reasons for this are complex and include various factors (...) including fears and beliefs held by patients. Cognitive factors are important modulators of pain and the appraisals, meanings and beliefs that people have in relation to illness, cancer, and pain, have implications in regard to help-seeking behaviours and the coping strategies people adopt. Cancer pain can impact a range of psycho-social factors across its course. Cancer pain relates to higher rates of psychological distress, anxiety and low mood, and the perception of pain intensity is, in turn, influenced by psychological factors. Cancer pain can negatively affect psychological health, and psycho-social factors can affect the pain experience. It has been suggested that people with a life-limiting illness experience ‘total pain’, and this can encompass psychological, social, practical, spiritual domains. Research demonstrates that cancer is predominantly an illness affecting older people, yet there is a higher risk of under-treated pain in this age group and there is a paucity of research into the subjective experiences of older people managing their cancer pain. Many older people are required to self-manage cancer pain at home as outpatients, due to drivers to keep people out of inpatient care, such as the high healthcare costs of inpatient treatment, and patients wanting to manage their illness, and die, at home. Our own research into this area found that the self-management of cancer pain involves a sequential and temporal process, which centres on perceptions of control. We describe how the older people in our study experienced a perceived loss of control, followed by a sense of gaining control over pain through various experience of certain internal and external factors. The assessment and treatment of physical pain should be done in combination with assessment and treatment of psycho-social and spiritual pain, and interventions for cancer pain need to focus on increasing positive affect and reducing helplessness. No person should suffer with poorly controlled pain and we argue for the need for further research in this area to ensure adequate treatment for all.Clinical Implications: Assessment and treatment of physical pain in people with cancer needs to be conducted in combination with assessment and treatment of psycho-social issues and spiritual pain. Psychological and behavioural approaches have strong evidence supporting their efficacy for reducing cancer pain. Interventions should target helplessness and focus on increasing positive affect through positive psychological states including fighting spirit and resilience. Person-centred interventions that focus on helping people with the search for meaning may help those with cancer pain derive positive benefits. (shrink)

Humans normally feel physical and mental pain. In this paper, we refer to physical pain as "pain in the body" and mental pain as "pain in the mind". We took an interest in the mechanism that makes a robot feel such pain in its mind and act appropriately to the sensation of pain. We developed a neural network program called MoNAD that can explain almost all of the phenomena of human consciousness. (...) We noted that the program outputed stable information on what had been learned but became unstable when unknown information was inputed or a system error occurred. We thought that we could create "pain in the mind" of robot by making use of this phenomenon. This paper proposes a demonstration of "pain in the mind" in robot. We expect that this research will also lead to a deeper understanding of humans. (shrink)

Frida Kahlo (1907–1954) was a Mexican artist who is remembered for her self-portraits, pain and passion, and bold, vibrant colors. This work aims to use her life story and her artistic production in a longitudinal study to examine with quantitative tools the effects of physical and emotional pain (rage) on artistic expression. Kahlo suffered from polio as a child, was involved in a bus accident as a teenager where she suffered multiple fractures of her spine and had (...) 30 operations throughout her lifetime. She also had a tempestuous relationship with her painter husband, Diego Rivera. Her physical and personal troubles however became the texture of her vivid visual vocabulary—usually expressed through the depiction of Mexican and indigenous culture or the female experience and form. We applied color analysis to a series of Frida's self-portraits and revealed a very strong association of physical pain and emotional rage with low wavelength colors (red and yellow), indicating that the expression of her ailments was, consciously or not, achieved by increasing the perceived luminance of the canvas. Further quantitative analysis that used the fractal dimension identified “The broken column” as the portrait with higher compositional complexity, which matches previous critical acclaim of this portrait as the climax of her art. These results confirm the ability of color analysis to extract emotional and cognitive features from artistic work. We suggest that these tools could be used as markers to support artistic and creative interventions in mental health. (shrink)

Bodily pain strikes many philosophers as deeply paradoxical. The issue is that pains seem to bear both physical characteristics, such as a location in the body, and mental characteristics, such being mind-dependent. In this paper I clarify and address this alleged paradox of pain. I begin by showing how a further assumption, Objectivism, the thesis that what one feels in one’s body when one is in pain is something mind-independent, is necessary for the generation of the (...) paradox. Consequently, the paradox can be avoided if one rejects this idea. However, doing so raises its own difficulties, for it is not obvious how anything can possess all of the features we typically associate with bodily pain. To address this puzzle and finally put the paradox of pain to rest, I develop the Embodied View, a novel metaphysical account on which pains are constitutively mind-dependent features of parts of a subject’s body. (shrink)

In this paper, I explore how our experience of pain and suffering structure our experience over time. I argue that pain and suffering are not as easily dissociable, in living and in conceptual analysis, as philosophers have tended to think. Specifically, I do not think that there is only a contingent connection between physical pain and psychological suffering. Rather, physical pain is partially constitutive of existential suffering. My analysis is informed by contemporary thinking about (...) pain and suffering as well as Indian Buddhist philosophy. (shrink)

The ArgumentThe study of pain in a historical context requires a consideration of the cultural context in which pain is sensed and expressed. This paper examines attitudes toward physical pain in the later Middle Ages in Europe from several standpoints: theology, law, and medicine. During the later Middle Ages attitudes toward pain shifted from rejection and a demand for impassivity as a mark of status to a conscious attempt to sense, express, and inflict as much (...) pain as possible. Pain became a positive force, a useful tool for reaching a variety of truths. While this attitude stemmed from the religious wish to identify with Christ's passion, it permeated and affected all spheres of cultural expression and investigation. Late permeated and affected all spheres of cultural expression and investigation. Late medieval medicine accepted pain, trying to relieve it only when it became dangerous to the patient. Given the existence of analgesic medicines at the time, this attitude is comprehensible only within the cultural context of the period. (shrink)

‘Writing Pain’ argues that Anna Seward‘s Letters and Mary Robinson‘s letters create alternative models of sensibility from the suffering poet of Charlotte Smith‘s Elegiac Sonnets. Immensely popular, Smith‘s sonnets made feminine suffering a source of poetic agency by aestheticizing and privatizing it. However, despite their sincerity, her sonnets effaced the physical, nervous body of sensibility on which Seward‘s and Robinsons early poetic reputations had depended and for which they had been mocked. The popularity of Smith‘s model made it (...) an important model for women poets, but, by the end of the eighteenth century, sensibility was also associated with sickness and artifice. For Seward and Robinson, who wanted to build their literary reputations but were living with disabled bodies, Smiths example needed to be reimagined to account for the reciprocity of body and mind as they struggled to write through pain. (shrink)

Sometimes the philosophical armchair gets bumped by empirical facts. So it is when thinking about pain. For good or ill (good, actually, as we shall see) most of us are intimately acquainted with physical pain, the kind you feel when you stand on a nail or burn your hand. And, from the armchair, it can seem blindingly obvious that pain is essentially unpleasant. There are of course unpleasant experiences that aren’t pains – nausea or itches, for (...) example – but surely there aren’t pains that don’t hurt, pains that are neutral or even pleasurable rather than unpleasant. Surely, indeed, there couldn’t be. For it is part of the very concept of a pain that a pain be unpleasant. Or so it has seemed to many. Yet over recent decades philosophers’ confidence in these putative truisms has been shaken by some fascinating cases from the clinic, the lab, and life. (shrink)

The meaning-maintenance model posits that any violation of expectations leads to an affective experience that motivates compensatory affirmation. We explore whether the neural mechanism that responds to meaning threats can be inhibited by acetaminophen, in the same way that acetaminophen inhibits physical pain or the distress caused by social rejection. In two studies, participants received either acetaminophen or a placebo and were provided with either an unsettling experience or a control experience. In Study 1, participants wrote about either (...) their death or a control topic. In Study 2, participants watched either a surrealist film clip or a control film clip. In both studies, participants in the meaning-threat condition who had taken a placebo showed typical compensatory affirmations by becoming more punitive toward lawbreakers, whereas those who had taken acetaminophen, and those in the control conditions, did not. (shrink)

Philosophers think of pain less and less as a paradigmatic instance of mentality, for which they seek a general account, and increasingly as a rich and fruitful topic in its own right. Pain raises specific questions: about mentality and consciousness certainly, but also about embodiment, affect, motivation, and value, to name but a few. The growth of philosophical interest in pain has gone hand-in-hand with the growth of pain science, which burgeoned in the 1960s. This is (...) no accident: developments in pain science have prompted philosophers to take account of empirical data, and to revisit their assumptions about pain. Pain, in short, demands interdisciplinary investigation, hence while this entry focuses on the philosophy of pain, it makes liberal reference to empirical literature along the way. This entry’s focus is on physical pains, that is pains that are felt in bodily locations, not emotional suffering more broadly, such as grief or disappointment. The entry also does not address pain’s place in ethical theories; its focus is rather on issues that arise within philosophy of mind. Even so, part of what makes pain such an interesting and important topic is that the questions it raises span boundaries, and normative questions concerning pain’s badness, on the one hand, and its value, on the other, are never far away. (shrink)

This chapter focuses specifically on the case of pain. Despite traditional opposition to the representational thesis, the latter has won widespread assent. The most important early proponents of the representational thesis were David Armstrong and George Pitcher, both of whom held that pain is a form of perception. Following Armstrong and Pitcher, intentionalists have traditionally held that the experience of pain has a content with roughly the following form: there is a disturbance with such-and-such features at location (...) L. Since the internal states associated with the experience of pain arguably track local physical properties of disturbances, it seems that the tracking intentionalist must identify the pain qualities represented by pain experience with these physical properties. But there are at least two important objections to the identification of pain qualities with local physical properties of disturbances. (shrink)

Functionalism of robot pain claims that what is definitive of robot pain is functional role, defined as the causal relations pain has to noxious stimuli, behavior and other subjective states. Here, I propose that the only way to theorize role-functionalism of robot pain is in terms of type-identity theory. I argue that what makes a state pain for a neuro-robot at a time is the functional role it has in the robot at the time, and (...) this state is type identical to a specific circuit state. Support from an experimental study shows that if the neural network that controls a robot includes a specific 'emotion circuit', physical damage to the robot will cause the disposition to avoid movement, thereby enhancing fitness, compared to robots without the circuit. Thus, pain for a robot at a time is type identical to a specific circuit state. (shrink)

ABSTRACTHardly a few people manage to escape big fears without dying [of them]; not so with pains. This statement captures Cardano's understanding of the difference between mental and physical pain. As a physician with a lifelong history of anxiety and alienation, Cardano inquired ceaselessly into the nature of the delicate interaction between the two kinds of pain. It was his belief that the subtle nature of mental suffering makes it difficult, if not impossible, to identify, name, and (...) give a meaning to those powerful emotions which cause our inner turmoil. Unable to be ‘named’ and ‘signified’, mental pain eludes understanding and thereby deprives the mind of its identity as a locus of sense. In the experience of physical pain, conversely, the mind can easily decode the signs in the body, keeping its mastery over sense-perception, the imagination, and desire. For this reason, Cardano believed, many people afflicted by sorrow and grief find solace in physical pain, which in its purest form is even able to enhance our cognitive potential. (shrink)

Theological anthropology can be enriched by paying attention to insights into human behavior taken from sociobiology. The capacity for reflective self‐consciousness enables the human animal to respond to basic instincts and drives in unprecedented ways. Humans follow gender‐specific sexual strategies, display aggressive behavior, and respond to physical pain as do other animals. Yet human beings have the intellectual ability to express these tendencies uniquely in either destructive or constructive ways. The human being, unlike any other animal, must reckon (...) with sexual ethics, the problem of violence, and the meaning of suffering. In developing the basic concepts of theological anthropology—good creation, natural evil, fall, sin, and image of God—sociobiological research can lead to more adequate understanding of the human. (shrink)

Physical pain has always been part of human experience, and throughout history it is recorded that doctors and wise men and women have sought to ease pain. The attitudes of those suffering pain, however, have varied from stoical acceptance to sullen endurance. Today, most people consciously seek to avoid pain or to have their pain eased, although they do not always expect what in fact appears to be possible. This study of 13 patients with (...) protracted pain was carried out at The London Hospital by a professional group to see how patients regarded their own pain and the efforts of doctors and nurses to relieve it. The attitudes of the doctors and nurses were also studied, and the results, despite the limitations of the survey, suggest that: [List: see text]. (shrink)

BackgroundPsychological distress/morbidity is amongst the primary reason for the cause of pain at multiple sites, its progression, and recovery. Though still not very clear if physical pain in the neck or the back may predict psychological morbidities or not. Thus, we investigated the association between combined neck or back pain and psychological distress/morbidity.MethodsA cross-sectional study was conducted in Al-Kharj, Saudi Arabia, including 1,003 individuals. The questionnaire comprised of General Health Questionnaire-12 and some questions about neck and (...) back pain. Data analysis was done using statistical software SPSS version 26.0.ResultsThe results of the multivariate analysis revealed a significant positive association between neck/back pain status and total GHQ score. Having neck/back pain had almost a 2.5 times greater risk of psychological distress/morbidity. Further, females were more likely to have a higher risk of psychological distress/morbidity than males while adjusting for sociodemographic and clinical characteristics.ConclusionThe combination of neck and back pain was significantly associated with the Saudi population’s psychological problems. Therefore, the Saudi government needs to devise high-risk strategies and allocate adequate resources to the cause so that at-risk people can be shielded from the adverse complications arising from this condition in the long run. (shrink)

This is a reasonably thorough consideration of various views regarding what pain is. Historical approaches to the problem are discussed and criticized. The two chapters, "Is Pain a Sensation?" and "Is Pleasure a Sensation?," serve as a good introduction to the difficulties of the issue. Much conceptual confusion due to ambiguity of the terminology is clarified. Also presented are contemporary views, including those based on recent empirical research. This leads to Trigg's conclusion that although physical pain (...) is usually regarded as both a sensation and an emotion, it is actually only a sensation, independent of the fact that it normally disturbs us.--B. L. (shrink)

The basis of having a direct moral obligation to an entity is that what we do to that entity matters to it. The ability to experience pain is a sufficient condition for a being to be morally considerable. But the ability to feel pain is not a necessary condition for moral considerability. Organisms could have possibly evolved so as to be motivated to flee danger or injury or to eat or drink not by pain, but by “pangs (...) of pleasure” that increase as one fills the relevant need or escapes the harm. In such a world, “mattering” would be positive, not negative, but would still be based in sentience and awareness. In our world, however, the “mattering” necessary to survival is negative—injuries and unfulfilled needs ramify in pain. But physical pain is by no means the only morally relevant mattering—fear, anxiety, loneliness, grief, certainly do not equate to varieties of physical pain, but are surely forms of “mattering.” An adequate morality towards animals would include a full range of possible matterings unique to each kind of animal, what I, following Aristotle, call “telos”. Sometimes not meeting other aspects of animal nature matter more to the animal than does physical pain. “Negative mattering” means all actions or events that harm animals—from frightening an animal to removing its young unnaturally early, to keeping it so it is unable to move or socialize. Physical pain is perhaps the paradigmatic case of “negative mattering”, but only constitutes a small part of what the concept covers. “Positive mattering” would of course encompass all states that are positive for the animal. An adequate ethic for animals takes cognizance of both kinds. The question arises as to how animals value death as compared with pain. Human cognition is such that it can value long-term future goals and endure short-run negative experiences for the sake of achieving them. In the case of animals, however, there is no evidence, either empirical or conceptual, that they have the capability to weigh future benefits or possibilities against current misery. We have no reason to believe that an animal can grasp the notion of extended life, let alone choose to trade current suffering for it. Pain may well be worse for animals than for humans, as they cannot rationalize its acceptance by appeal to future life without pain. How can we know that animals experience all or any of the negative or positive states we have enumerated above? The notion that we needed to be agnostic or downright atheistic about animal mentation, including pain, because we could not verify it through experience, became a mainstay of what I have called “scientific ideology”, the uncriticized dogma taught to young scientists through most of the 20th century despite its patent ignoring of Darwinian phylogenetic continuity. Together with the equally pernicious notion that science is “value-free”, and thus has no truck with ethics, this provided the complete justification for hurting animals in science without providing any pain control. This ideology could only be overthrown by federal law. Ordinary common sense throughout history, in contradistinction to scientific ideology, never denied that animals felt pain. Where, then, does the denial of pain and other forms of mattering come from if it is inimical to common sense? It came from the creation of philosophical systems hostile to common sense and salubrious to a scientific, non-commonsensical world view. Reasons for rejecting this philosophical position are detailed. In the end, then, there are no sound reasons for rejecting knowledge of animal pain and other forms of both negative and positive mattering in animals. Once that hurdle is cleared, science must work assiduously to classify, understand, and mitigate all instances of negative mattering occasioned in animals by human use, as well as to understand and maximize all modes of positive mattering. (shrink)

Back injuries have a bad reputation. The workman looks upon them with apprehension, the insurance company with doubt, the medical examiner with suspicion, the lawyer with uncertainty. The medical examiner is faced with the difficulty of estimating the true value of the subjective symptoms in the comparative absence of physical signs. His suspicion is born of the frequent disparity between these two. This prophetic statement made almost 100 years ago highlights an ongoing problem - how people who are incapacitated (...) by painful conditions such as chronic low back pain can be evaluated consistently and equitably for purposes of disability compensation. We confronted this vexing problem when we participated in writing the chapter devoted to impairment associated with pain of the American Medical Association s Guides to the Evaluation of Permanent Impairment, 5th edition AMA Guides 5th Our purposes in this essay are to clarify several important conceptual issues associated with the assessment of pain among disability applicants, and to articulate reasons why pain should be considered in impairment and disability ratings. (shrink)

According to recent evidence, neurophysiological processes coupled to pain are closely related to the mechanisms of consciousness. This evidence is in accordance with findings that changes in states of consciousness during hypnosis or traumatic dissociation strongly affect conscious perception and experience of pain, and markedly influence brain functions. Past research indicates that painful experience may induce dissociated state and information about the experience may be stored or processed unconsciously. Reported findings suggest common neurophysiological mechanisms of pain and (...) dissociation and point to a hypothesis of dissociation as a defense mechanism against psychological and physical pain that substantially influences functions of consciousness. The hypothesis is also supported by findings that information can be represented in the mind/brain without the subject’s awareness. The findings of unconsciously present information suggest possible binding between conscious contents and self-functions that constitute self-representational dimensions of consciousness. The self-representation means that certain inner states of own body are interpreted as mental and somatic identity, while other bodily signals, currently not accessible to the dominant interpreter’s access are dissociated and may be defined as subliminal self-representations. In conclusion, the neurophysiological aspects of consciousness and its integrative role in the therapy of painful traumatic memories are discussed. (shrink)

In a recent article in this journal, Carl Knight and Andreas Albertsen argue that Rawlsian theories of distributive justice as applied to health and healthcare fail to accommodate both palliative care and the desirability of less painful treatments. The asserted Rawlsian focus on opportunities or capacities, as exemplified in Normal Daniels’ developments of John Rawls’ theory, results in a normative account of healthcare which is at best only indirectly sensitive to pain and so unable to account for the value (...) of efforts of which the sole purpose is pain reduction. I argue that, far from undermining the Rawlsian project and its application to problems of health, what the authors’ argument at most amounts to is a compelling case for the inclusion of freedom from physical pain within its index of primary goods. (shrink)